Board of Nursing Practice Proposals Still a Concern

At the August 5 meeting of the Minnesota Board of Nursing, the Board's Nursing Practice Committee submitted its formal recommendation regarding the LPN scope of practice issue. 

• Read the recommendation in its entirety  8-5-10 Nursing Practice Committee Report and Recommendation.pdf
• Read MNA's formal notification of our position sent to the Board on Aug. 4  Letter to MN Board of Nursing 8-4-10.pdf

Additional History

The Minnesota Board of Nursing’s Nursing Practice Committee met Monday July 19th to continue discussions related to redefining LPN scope of practice. The board’s practice committee has been working on this issue for many years. In 2002, LPN educators requested the MBON, and a now defunct Robert Wood Johnson funded group (labeled MN Colleagues in Caring), “to address the perceived differences between practical nursing practice and the scope of practice specified by regulation” (MBON Draft 3, Implementation of Recommendations, 7/2010). An LPN practice committee was formed by the MBON.

MNA was allowed two members and one staff as representatives on this committee. If they had to be absent, no substitutes were permitted. In the end there was little agreement and several recommendations were made to the board of nursing.

1. The nature of observation and assessment in practical nursing practice needs to be clarified and differentiated from observation and assessment in professional nursing practice.
2. The nature of delegation and supervision in practical nursing practice needs to be clarified and differentiated from observation and assessment in professional nursing practice.
3. Ongoing education of those in supervisory positions is needed, with clear examples of how to communicate the role differentiation of practical nursing practice and professional nursing.

MNA has made it very clear that differentiating and clarifying practice would not include expanding LPN scope of practice to include assessment, delegation, and supervision. Rather, supervisors, LPNs, and RNs should be better educated about the Grounds for Discipline including practicing beyond one’s legal scope of practice; and that the MBON should pursue discipline of persons both performing outside their scope, and those allowing it.

The board of nursing then gave these charges to the Nursing Practice Committee:

• Analyze the recommendations of the LPN scope of practice work
• Determine a plan to implement the recommendations  of the LPN scope of practice work

The Practice Committee presented it 3rd Draft of Implementation of Recommendations of the MN Colleagues in Caring LPN Practice Committee (which MNA has been objecting to). There is a great deal of editing left to do, including narratives for the models, but the nursing board committee members plan to submit the report to the August 5th MBON meeting for approval. Many changes have been made but the fundamental concerns of expansion of LPN practice, the use of committee rather than the legislative process for law changes, and the continuing lack of clarity between LPN and RN roles, remain.  Early next week, MNA will send a formal response to the Board's Practice Committee outlining these concerns.  However, MNA members should be prepared for an outcome that does not reflect our concerns.

NOTE: Click on the images below to see them at full size.